What to Expect During Defecography

A defecography, is a test in which a series of X-rays are taken as a patient goes through the process of having a bowel movement to assess for the presence of any structural or functional problems. A thick barium paste is used to provide contrast for the X-ray images. Defecography allows your doctor to see what actually occurs in the areas of your rectum and anus when you try to eliminate stool of any structural or functional problems.

A thick barium paste is used to provide contrast for the X-ray images. Defecography allows your doctor to see what actually occurs in the areas of your rectum and anus when you try to eliminate stool.

When Is Defecography Used?

Actually, defecography is not a commonly prescribed procedure. However, it may be useful for gaining information as to why you might be experiencing:

• Anal pain
• Chronic constipation
• Dyssynergic defecation
• Fecal incontinence
• Incomplete evacuation requiring digital evacuation

Defecography can also help to identify the following:

• Rectal prolapse
• Cystocele (bulging of the bladder into the vagina)
• Enterocele (bulging of the small bowel into the vagina and the rectum)
• Rectocele (bulging of the wall of the rectum into the vagina)

The usefulness of defecography is enhanced when it is done in conjunction with a functional MRI, a procedure called, of course, MRI defecography.

What to Expect During a Defecography Procedure

Unlike a colonoscopy, you may not necessarily need to undergo a complete clean-out prep.

Some centers, but not all, may ask that you use an enema shortly before your appointment. You will be asked to refrain from eating for two hours prior to your exam.

During your exam, a thick barium paste will be slowly injected into your rectum through your anus. The solution will stimulate the need to empty your bowels.

You will then be directed to sit on a special toilet so that you can evacuate the paste. You will be asked to squeeze and strain as you push out the paste. While this is happening X-ray video will be taken. The procedure typically takes approximately 15 to 30 minutes. You may experience some slight discomfort, but the test is not painful.

Some centers may ask you to swallow a barium solution as well so as to get X-rays of your small intestine. This would happen approximately one hour before the procedure begins. If you are a woman, you may find that they insert the barium paste into your vagina as well.

Limitations of Defecography

Research has indicated that the findings of a defecography are not always accurate as they are dependent on the training and experience of the test interpreter. Therefore, if you are to undergo a defecography procedure, be sure that the procedure is conducted by, and the results are interpreted by, experts in anorectal motility.

As stated above, an alternate procedure is the MRI defecography. An MRI can offer a more in-depth look as to what might be going wrong than a reliance on X-rays. It may be best to have a discussion with your doctor about the two options so you can feel confident that the best choice has been made for you.

Also Known As:

• Barium defecography
• Evacuation proctography
• Fluoroscopic defecography
• Proctography

_Sources:

_{Kim, A. "How to Interpret a Functional or Motility Test - Defecography" Journal of Neurogastroenterology and Motility 2011 17:416–420.}

_{Olson, C. "Diagnostic Testing for Fecal Incontinence" Clinics in Colon and Rectal Surgery 2014 27:85–90.}